Alternative medicine is any practice that is put forward as having the healing effects of medicine, but does not originate from evidence gathered using the scientific method and has not proven to be effective1. The phrase complementary and alternative medicine is used to describe a group of diverse medical and health care systems, practices, and products that have historic origins outside mainstream medicine.2 Incidentally, the above line is from the revered textbook Harrison’s principles of internal medicine, which, in medical circles is called ‘The Bible’ of Medicine. This epithet couldn’t be farther from the truth. Harrison, unlike the Bible, requires that the reader have absolutely NO faith in it. It gives references to every claim it makes, pointing to studies which substantiate those claims. It provides pedantic statistics from these studies about various probabilities and predictions based on them. It urges you not to believe it at face value and to investigate instead.
AYUSH(Ayurveda, Yoga, Unani, Siddha, Homeopathy) – alternative medicine in India, has government recognition, support, and funding.
Before getting to the attack on AYUSH, and to the debunking of the common arguments in its defence, I would like to give a quick overview of how scientific medicine works in the development of any drug.
- Drug design or Drug discovery. A new substance is discovered in nature or produced in a lab. ‘Discovering’ a drug in products already in use in traditional medicine like Ayurveda would be considered part of this phase – NOT as a bonafide finished product ready for use in humans.
- Preclinical. The drug is tested at various doses in animals for toxicity, efficacy and its properties.
- Phase 0. Very small doses are given to a small number of humans to observe how the drug is absorbed and how it behaves inside the body.
- Phase 1. Dose – ranging is done to determine if the drug is safe
- Phase 2. A therapeutic dose is given to check for efficacy as well as safety
- Phase 3. Now, after the drug’s safety has been established, it is determined if this drug has the desired therapeutic effect or not. This phase is conducted in a very large number of patients, in controlled environments, after carefully eliminating any biases or confounding factors. The patient, the doctor as well as the researcher are all blind(triple blind) to whether a placebo was administered or the actual drug.
- Phase 4. Post-marketing surveillance, to see if the drug has any long term effects that were not readily apparent in the pre marketing phases.
This is the scientific method. It is NOT infallible. Trials are subject to error and biases. Large financial investments in drug research lead to vested interests in favourable results for the drug. Yet, despite the odds, this is the best we have. This method provides us with good solid numbers, the numbers that form the backbone of science. Numbers like, ‘x is the likelihood of suffering from ‘p’ side effect due to drug A’, the chance of a complete cure by using the drug ‘B’ is y%’ etc. Rarely do the numbers claim that any drug is ‘absolutely safe’, or ‘absolutely effective’.
The doctor’s job is to understand the numbers, ‘feel’ them through experience, juggle the probabilities, and finally apply the result in a rational scientific way.
Can AYUSH be considered Science, or even Medicine?
The answer is a loud and resounding NO.
AYUSH does not follow the scientific method. In fact, it categorically states that the scientific method cannot and should not be applied to it. Trials of the kind described above cannot be performed on AYUSH treatments as the treatment isn’t specific to a certain disease condition, but is a ‘holistic’ cure. And each person has a different ‘personality’ or ‘balance of humors’ or other such completely arbitrary concepts. A common treatment cannot be prescribed for a thousand patients and then judged statistically, because practitioners of AYUSH claim no thousand patients would require the exact same treatment. If it does not allow itself to be analysed by the scientific method, it should not be called a science.
Is it medicine? Medicine, one presumes, must have some therapeutic value. I.e. it should be shown to be effective. Unfortunately, Ayurveda and Homeopathy have consistently failed to show any therapeutic value superior to placebo.
Common arguments to justify Ayurveda and Homeopathy
It works on the placebo effect.
This argument is fallacious. It means it DOESN’T work. Nevertheless, even if there were such a thing as a ‘placebo effect’ which magically cured diseases, then a far more reasonable option would be to administer placebos which have proven safety profiles, like say sugar pills. Not dangerous extracts from plants, or toxic heavy metals3
It’s natural, so it’s safe and without side effects unlike modern medicine.
Natural does not mean safe. To verify this, I recommend chewing a few seeds of dhatura. Anyone who has had the ‘natural’ ‘remedy’ of castor oil will also tell you of its very unpleasant side effects. Many, if not most drugs used in modern medicine are plant/fungal/animal extracts, and not designer molecules generated in a lab. Most of them have some deleterious effects, there is no reason why Ayurvedic concoctions cannot. But unlike scientific medicine, Ayurvedic concoctions do not come with little slips of paper warning the user of the potential hazards, nor does one have the luxury of finding studies on the same. One simply cannot know what will happen, if anything is to happen at all.
My auntie had a condition which wasn’t getting cured despite the best treatment, she went to an Ayurvedic/Homeopathic doc and voila! She’s fit as a fiddle.
In medicine, this counts as anectodal evidence, which has absolutely no value compared to a clinical trial. It may, on occasion be true. But there is no way to identify confounding factors. Did the said auntie change her diet along with her doctor which cured her? Did the conventional medicine start working at just the point that she abandoned it in favour of alternate medicine? Did the Ayurvedic doctor do something utterly unethical to get instant results(a topic I shall touch upon later in the article).
Well, it may not be effective, but surely it can’t hurt right? Better take both, conventional as well as AYUSH, better be on the safer side.
As with the previous arguments, there is no way of saying whether or not ‘it cant hurt right?’ Many drugs interfere with the functioning of other drugs. In modern medicine, this has been extensively studied for every drug, and doctors are aware which drugs not to give with which other drugs or how to modify doses appropriately. Since such information is not available for Ayurveda and Homeopathy, there is no way to judge.
Our ancestors never had access to modern drugs. They lived long lives, free from disease.
Evidence shows that modern medicine has more than doubled life expectancy. It has improved general health standards. Our ancestors could be crippled by a virus as weak as polio, which our children will never have to fear. Our ancestors could literally go insane due to syphilis when it can be cured completely by a simple antibiotic. The ‘glorious past’ is a myth that should be disposed with. We live in a glorious present where we die of old age and heart disease brought on by our own eating habits.
Modern medicine has its limits. The doctor said nothing can be done, so we’re trying AYUSH.
This approach is dangerous. There is no telling what the Ayurveda or Homeopathy treatment will do. If the prognosis given by the scientific doctor is very very poor and he has given only a few days or weeks to live, perhaps trying out anything is worth a shot. But if the said condition isn’t immediately life threatening, then AYUSH may complicate matters. It may have unpredictable effects in completely unrelated systems of the body. It may leave you worse off than where you started. Atleast the scientific doctor can predict what will happen to you with a fair bit of statistical accuracy.
My experience with Ayurveda and Homeopathy and why I oppose it
The patient who goes to the honest Ayurvedic/ Homeopathic doctor for treatment.
Patients suffering from chronic long standing conditions which do not cause acute painful symptoms often go to Ayurvedic or Homeopathic doctors. There are a myriad reasons why they prefer these doctors. The first being that they do not recognise the value of the scientific method and do not realise that those ‘doctors’ are not doctors and their ‘science’ isn’t a science. Other more relevant reasons are that AYUSH practitioners usually charge lower fees and their medicines are usually less expensive(as they do not undergo the expensive processes of clinical trials, packaging, quality control etc)Some patients in remote parts of the country simply do not have access to genuine doctors.
Now, these patients end up receiving ‘treatment’ for these conditions for long periods of time. Since conditions like diabetes, glaucoma do not cause acute symptoms like pain, there is no way for a patient to judge whether or not treatment is working. Often, the treatment continues, and so does the disease process. Damage caused due to glaucoma and diabetes is irreversible, once it occurs. The treatment is based on PREVENTION of damage. And this is possible only with early treatment. These patients come to us scientific doctors once the damage has occurred, when the symptoms begin to show. When they begin to realise that their ‘treatment’ isn’t working. By then, it is too late.
I have personally treated many patients with end stage diabetic eye disease, going blind, losing their kidneys, ending up with rotting dead limbs who claim they never missed a doctor’s appointment and did everything the doctor advised. It sickens me to tell them they were fooled, but it is now too late. Many of my patients have become blind due to glaucoma, having been treated with water diluted a hundred times to increase the homeopathic drugs potency, or some concoction of Ayurvedic crushed leaves and breastmilk.
This is the state of affairs with well-meaning Ayurvedic and Homeopathic doctors, who believe in their ‘science’, and do not adulterate their medicine. Neither faith in their ‘science’ nor good intentions can bring back the light in those blind eyes. Nor can they bring back the dead.
The patient who goes to a dishonest Ayurvedic/Homeopathic doctor for treatment
Some practitioners of AYUSH, after a while, begin to realise their treatment doesn’t really work. But once in the trade, they have mouths to feed, and few options. They must provide results, but their medicines just don’t work. Genuine medical knowledge isn’t so easy to obtain and takes a decade of intense learning, a luxury they do not have.
In a quandary, they turn to steroids. Steroids cause a feeling of well-being. They alleviate minor aches and pains. They increase appetite and make one happy. Used as eye drops, they eliminate general irritation and grittiness of the eyes (a symptom almost everyone has at some time or the other), give a sense of well-being and comfort.
But steroids also cause diabetes, peptic ulcers; they make the patient susceptible to infection. Used in the eyes, they cause cataracts and glaucoma.
In my experience, I have found many formulations given by Ayurvedic and Homeopathic practitioners are laced with steroids. This gives immediate comfort to the patient from whatever symptom he is suffering without altering the disease process, and which eventually leads to complications. The immediate comfort makes the patient satisfied. Most often the patient never realises the complications that occur later are due to these same formulations.
Should research be done on Ayurveda or Homeopathy?
Many drugs in use today are derived from plants(like atropine, pilocarpine). Many have been in use in traditional medicine since centuries. Cleopatra allegedly used the belladonna(beautiful lady) plant from which atropine is obtained to dilate her pupils to appear more alluring.
These drugs came into the ambit of scientific medicine only when they underwent systemic clinical testing. Until then, they were simply traditional remedies, neither proven effective, nor safe. In fact, atropine, now a very commonly used drug is also a very potent poison.
The question ‘should research be done on Ayurveda’ is often misinterpreted as ‘Should research be done on the plants and other products used in Ayurveda’. This is illogical. Ayurveda implies much more than the plants and roots it uses. It implies a belief in the tri dosha theory and other tenets which have no scientific rationale.
The answer to ‘should research be done on the plants and other products used in Ayurveda’ is YES.
And the fact is, it is already being done. Pharmaceutical companies which spend billions of dollars on research on new drugs find it economically more feasible to identify chemicals already existing in nature with potential therapeutic qualities than to design molecules in laboratories from scratch. This is why so many drugs have origins in nature. The government, if it is interested in funding research on new drugs should invest in SCIENTIFIC MEDICINE, even if the drugs being researched are of natural origin.
The answer to ‘should research be done on Ayurveda or Homeopathy’ is NO. The concepts of Ayurveda, and Homeopathy are not consistent with facts of science. They have not been substantiated experimentally. Therefore, AYUSH does NOT merit ANY research, especially that endorsed by the taxpayer. If one claims that everything deserves research, and that one cannot be sure that one will not find something of use in these ‘sciences’, the same logic must be applied to every other equally frivolous claim (amusing examples of which are the Flying Sphaghetti Monster which can treat any disease with its noodly appendage and the tooth fairy which specialises in dental problems)
To conclude I urge fellow freethinkers not to fall prey to the quackery that is AYUSH or any other alternative medicine. It is not only ineffective, but also harmful.
- National Science Board (2002). “Chapter 7: Science and Technology: Public Attitudes and Public Understanding, Section: Belief in Alternative Medicine”.Science and Engineering Indicators – 2002. Arlington, Virginia: Division of Science Resources Statistics,National Science Foundation, US Government.
- Harrison’s Principles of Internal Medicine 2015, p. 1, chpt. 14-E
- “Lead Poisoning Associated with Ayurvedic Medications — Five States, 2000–2003”. Morbidity and Mortality Weekly Report (Centers for Disease Control and Prevention) 53 (26): 582–584. 9 July 2004.